Description
MSHP seeks a Clinical Documentation Specialist who will support efforts to improve the overall quality and completeness of clinical documentation and coding in outpatient physician practices. They will work closely with physicians, Health Information Management and the Mount Sinai Health Partners team to review and code ambulatory medical records, identify opportunities to improve coding, educate physicians, and act as a liaison between all parties.
Responsibilities
- Facilitates improvement in the overall quality, completeness and accuracy of medical record documentation and coding.
- Reviews charts to assess the clinical status of patients, current treatment plan, and past medical history to identify potential gaps in clinical documentation related to outpatient encounters, with a particular focus on primary care visits.
- Performs on-site or electronic coding and clinical validation audits and interpretation of medical documentation to ensure capture of all relevant coding. A particular focus with be on Hierarchical Condition Categories (HCC) coding, which is used by CMS and other payers to determine illness complexity and estimate patient risk of future health care utilization.
- Leverages data provided by available information technology (such as billing data) to identify additional opportunities to improve the comprehensiveness and specificity of outpatient coding
- Communicates and coordinates chart reviews with physician office staff and distributes correspondence related to review.
- Analyzes returned CDQI alerts for accuracy and completeness
- Reviews outpatient visit diagnoses and service levels prior to claim submission to ensure they accurately reflect the clinical status of patients and the type of care delivered
- Proactively solicits clarification from physicians to ensure key aspects of care have been appropriately recorded in the patient’s chart
- Participates in data acquisition, development of performance reports and communication of results to physicians, practice managers, and the CDQI leadership team
- Interacts regularly with physicians, particularly primary care providers, in the outpatient setting, providing ongoing education regarding compliant documentation and accurate coding, and serves as clinical liaison to the coding department
- Identifies training needs, prepares summary reports and conducts coaching as appropriate for clinicians and other staff to improve the quality of the documentation to accurately reflect members’ health status.
- Monitors coding changes by governmental agencies and other payers; educates practices on coding and compliance issues
- Monitors activities to ensure that all clinical documentation is in compliance with State and Federal payer regulations
- Performs other related duties
Qualifications
Education and Experience
- High school diploma or general education degree (GED); Associates or greater preferred
- Must have a minimum of 3 years coding experience
- At least 1 year of HCC Risk Adjustment experience, preferred
- Clinical background in a healthcare setting, preferred
- Credentials in one or more of the following, required:
- Certified Coding Specialist (CCS)
- Certified Risk Adjustment Coder (CRC)
- Certified Professional Coder (CPC)
Additional Skills And Qualities
- Demonstrated experience with front-end process improvement initiatives
- Thorough knowledge of ICD-10, CPT, and HCPCS
- Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements
- Familiarity with APC coding
- Experience with Microsoft Excel and Strong communication and mentoring skills
- Ability to communicate clearly and effectively with a wide variety of individuals at all levels of the organization
- Strong time management skills
- Excellent organization skills
- Must possess high degree of accuracy, efficiency and dependability
- Excellent written and oral communication for representation of clear and concise results
Licensing and Certification Requirements (if applicable)
- Credentials in one or more of the following, required:
- Certified Coding Specialist (CCS)
- Certified Risk Adjustment Coder (CRC)
- Certified Professional Coder (CPC)
Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital
Employer Description
Strength Through Diversity
The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:
- Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.
- Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.
- Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.
At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.
Explore more about this opportunity and how you can help us write a new chapter in our history!
“About the Mount Sinai Health System:
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.
The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”
EOE Minorities/Women/Disabled/Veterans
Compensation
The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $65885 - $98827 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
